Research: Exercise and Physiotherapy for MS

Using exercise and physical therapy for recovery from the effects of MS, and for maintaining physical function.
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2018 study: Aging,Active vs Sedentary Life & Function in MS

Post by jimmylegs » Sun Sep 23, 2018 1:07 pm

kind of common sense but yeah

Physical Activity, Sedentary Behavior, and Physical Function in Older Adults With Multiple Sclerosis (2018)
https://journals.humankinetics.com/doi/ ... .2016-0358

Older adults with multiple sclerosis (MS) experience the combined effects of aging and a chronic, disabling neurological disease on physical activity, sedentary behavior, and physical function. This study examined associations among light and moderate-to-vigorous physical activity (LPA and MVPA), sedentary behavior, and physical function in older adults with MS. Forty older adults with MS (median age = 60 years) who had a median Expanded Disability Status Scale score of 4.5 wore an accelerometer for a 7-day period and completed the Short Physical Performance Battery (SBBP), 6-minute walk (6MW), and timed 25-foot walk (T25FW). LPA was associated with SPPB (rs = .551, p < 0.01), 6MW (rs = .660, p < 0.01), and T25FW (rs = .623, p < 0.01) scores; MVPA was associated with 6MW (rs = .529, p < 0.01) and T25FW (rs = .403, p < 0.01) scores. There were significant associations between LPA, but not MVPA, with SPPB (β = .583, p < 0.01), 6MW (β = .613, p < 0.01), and T25FW (β = .627, p < 0.01) scores in linear regression analyses. Older adults with MS who engaged in more LPA demonstrated better physical function and therefore light physical activity might be a target of future behavioral interventions.
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don't let suboptimal self care muddy any underlying diagnostic picture!

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Re: Harvard: For people with MS, can exercise change the bra

Post by Petr75 » Fri Oct 12, 2018 10:02 am

2018 Sep 18
Hotchkiss Brain Institute and the Department of Clinical Neurosciences University of Calgary, Calgary, AB, Canada
Multimodal Enhancement of Remyelination by Exercise with a Pivotal Role for Oligodendroglial PGC1α
https://www.ncbi.nlm.nih.gov/pubmed/30232000

Abstract
Remyelination is a multistep regenerative process that results in the reformation of myelin sheaths around demyelinated axons and is a critical therapeutic target. Here we show that immediate access to a running wheel following toxin-induced demyelination in mice enhances oligodendrogenesis, the rate of remyelination, and the proportion of remyelinated axons. RNA sequencing suggests broad activation of pro-remyelination pathways including phagocytosis by exercise and highlights peroxisome proliferator-activated receptor gamma co-activator 1-alpha (PGC1α) activation. By immunohistochemistry and cell type-specific conditional deletion, we confirmed PGC1α within oligodendrocytes as a transiently expressed factor required for the rate of myelin thickening by exercise. We validated the exercise-enhanced clearance of inhibitory lipid debris from lesions. Finally, exercise works in parallel with the remyelinating medication clemastine to produce complete remyelination of lesions. Our study demonstrates physical activity as an integrative means to enhance remyelination and details a multimodal mechanism including the pivotal PGC1α-dependent enhancement of myelin thickness.

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Re: Harvard: For people with MS, can exercise change the bra

Post by Zyklon » Fri Oct 12, 2018 10:26 am

Finally, exercise works in parallel with the remyelinating medication clemastine to produce complete remyelination of lesions.
Please please please more research. Tons of drugs research but very few exercise related ones.
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Re: Harvard: For people with MS, can exercise change the bra

Post by jimmylegs » Sat Oct 13, 2018 7:50 am

ok time for some research wish list specifics.

without patents or citations, for 2018 alone it looks like we have 5490 results and counting:
https://scholar.google.ca/scholar?as_vi ... s_ylo=2018

yes, there are 5530 for interferon but who's counting ;)
https://scholar.google.ca/scholar?hl=en ... s%22&btnG=

so, where's the specific research gap of interest z?
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Re: Harvard: For people with MS, can exercise change the bra

Post by Petr75 » Sat Oct 13, 2018 11:04 am

Thanks

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Re: Harvard: For people with MS, can exercise change the bra

Post by Zyklon » Sun Oct 14, 2018 6:12 am

MS specialized exercise routines. Comparing different types of exercises. Remyelination promoting exercises. Exercise and dmd interactions.
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Re: Harvard: For people with MS, can exercise change the bra

Post by Petr75 » Sun Oct 14, 2018 7:57 am

What fight?
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Kickboxing: A creative approach to improving balance in patients with MS http://lermagazine.com/cover_story/kick ... -sclerosis

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Re: Harvard: For people with MS, can exercise change the bra

Post by jimmylegs » Sun Oct 14, 2018 8:28 am

i think there are a bunch but it's one thing to have an abstract and something else to have full text. without the latter, i'd probably still be seeing double!
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Re: Harvard: For people with MS, can exercise change the bra

Post by Petr75 » Wed Nov 07, 2018 8:10 am

2018 Sep 28
Neurorehabilitation, Fondazione Don Carlo Gnocchi Onlus (IRCCS), Milan, Italy
Intensive Multimodal Training to Improve Gait Resistance, Mobility, Balance and Cognitive Function in Persons With Multiple Sclerosis: A Pilot Randomized Controlled Trial
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172314/

Abstract
Introduction: Persons with multiple sclerosis (MS) have deficits in many aspects of physical and cognitive functioning that can impact on mobility and participation in daily life. The effect of a 4 week intensive multimodal treadmill training on functional mobility, balance, executive functions and participation in persons with MS with moderate to severe disability was investigated. Methods: Thirty eight persons with MS admitted to a rehabilitation center participated in a two arm randomized 2:1 controlled trial. Participants in the experimental group received supervised intensive treadmill training including cognitive and motor dual tasks (DT-group, N = 26), 5 sessions per week and a control group received the same amount of supervised strength training (S-group, N = 12)....

Conclusion: A four week multimodal training on treadmill was highly effective in augmenting gait resistance and mobility in moderately to severely affected persons with MS.

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source img https://obehani.cz/bezecky-pas-vyhody-nem-trenovat/
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2018 Jul 25
Swedish Neuroscience Institute, Swedish Medical Center , Seattle
https://www.ncbi.nlm.nih.gov/pubmed/30044680

Abstract
INTRODUCTION:

Recently published studies show remarkable improvements in functional mobility after treadmill training with HAL® in patients with spinal cord injuries. The aim of this study was to evaluate the impact of HAL®-assisted treadmill training on quality of life. Patient/Method: A case series of six patients participating in a single-centre prospective, interventional pilot study, who were suffering neurologic motor deficits. The quality of life was assessed using the EQ-5D questionnaire and mobility was assessed using the PROMIS v1.2 Physical Function - Mobility Score before treadmill training, at 12-weeks, and at 6-months.
RESULTS:
Five out of six patients showed improvement in the PROMIS v1.2 Physical Function - Mobility score. Four patients did not show changes in the EQ-5D at 6 months follow-up, relative to baseline. The EQ-5D score of one patient worsened while improved in another patient at 6 months follow-up compared to the baseline.
CONCLUSION:
Our study details the first experience in a larger series regarding the effects of HAL®-assisted treadmill training on quality of life. Whereas five out of six patients showed improvements in mobility scores, only one patient showed improvement of life quality at 6 months follow-up. Life quality is influenced by a multitude of factors and lager randomized trials are needed to assess the effect of HAL®-assisted training on quality of life. Implications for Rehabilitation Treadmill training with HAL is safe and feasible for patients with neurologic disorders Treadmill training with HAL improved the functional mobility Improvements in the quality of life were unverifiable.

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https://ereska.net/

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Re: Harvard: For people with MS, can exercise change the bra

Post by Petr75 » Sun Nov 11, 2018 8:56 am

2018 Oct 18
Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, Illinois, United States of America
Targeted ballet program mitigates ataxia and improves balance in females with mild-to-moderate multiple sclerosis.
PMC https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193654/

Abstract
BACKGROUND:
Multiple sclerosis (MS) is a disease of the central nervous system that causes ataxia and deficits in balance. Exercise-based therapies have been identified as integral to the recovery of motor function in MS, but few studies have investigated non-traditional movement interventions. We examined a targeted ballet program (TBP) designed to mitigate ataxia and improve balance in females with mild-to-moderate relapsing-remitting MS.
METHODS AND FINDINGS:
Twelve females with mild-to-moderate disability due to MS were assessed for study eligibility for the study. Ten participants met the inclusion criteria. Two were lost to unrelated health complications. Eight participants completed the TBP. The TBP met twice a week for 60 minutes for 16 weeks. Assessments included (a) the International Cooperative Ataxia Rating Scale (ICARS), (b) the Mini-Balance Evaluations Systems Test (Mini-BESTest), (c) smoothness of movement during a five-meter walk, and (d) balance in a step to stand task before and after the TBP. There were no TBP-related adverse events. Single-tailed paired samples t-tests and Wilcoxon tests were conducted. Improvements were observed in ICARS (p = 7.11E-05), Mini-BESTest (p = 0.001), smoothness of movement in the left (p = 0.027) and right (p = 0.028) sides of the body, and balance in a step-to-stand task in the back (p = 0.025) direction. Results yielded 42% and 58% improvements in the mean Mini-BESTest and ICARS scores, respectively.
CONCLUSIONS:
This study adds to current research by providing support for a TBP intervention targeting ataxia and balance in MS. The TBP was well tolerated, improved balance, and mitigated ataxia. Clinical improvements were larger than those of previous studies on physical rehabilitation in MS with similar outcome measures.

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2018 study: athletes need more zinc (stop the presses!)

Post by jimmylegs » Sat Dec 01, 2018 6:17 am

whew, lucky they've been making active multis all this time huh

Lower Serum Zinc Concentration Despite Higher Dietary Zinc Intake in Athletes: A Systematic Review and Meta-analysis (2018)
https://www.ncbi.nlm.nih.gov/pubmed/29164533

CONCLUSIONS:
Despite higher total dietary zinc intake, athletes generally have lower serum zinc concentration, which suggests that athletes have higher requirement of zinc than those who are physically inactive. Further investigations of zinc metabolism during exercise and dietary zinc requirement in active populations are needed to establish evidence-based recommendations.

ps. three hours later, jl notices the double-entendre...
take control of your own health
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ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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2018 meta-analysis: PT for MS spasticity

Post by jimmylegs » Fri Jan 11, 2019 6:54 am

Effectiveness of Physiotherapy Interventions on Spasticity in People With Multiple Sclerosis
A Systematic Review and Meta-Analysis
https://journals.lww.com/ajpmr/Abstract ... _on.4.aspx

"Results A total of 29 studies were included in the review, and 25 were included in the meta-analyses. The included PT interventions were exercise therapy, electrical stimulation, radial shock wave therapy, vibration, and standing. The review and meta-analyses showed different evidences of benefits and nonbenefits for PT interventions on some spasticity outcomes. The best quality evidences were for beneficial effects of exercise therapy especially robot gait training and outpatient exercise programs on self-perceived spasticity and muscle tone respectively. The review results were positive regarding the acute effects, follow-up measurements, safety, progressive MS, and nonambulatory people with multiple sclerosis. The included articles were heterogeneous and badly reported in PT interventions and people with multiple sclerosis characteristics.

Conclusions Physiotherapy interventions can be a safe and beneficial option for spasticity in people with multiple sclerosis. No firm conclusion can be drawn on overall spasticity. Further researches in different spasticity aspects are needed."
take control of your own health
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ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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2018 RCT: aquatic exercise intervention for MS

Post by jimmylegs » Fri Jan 11, 2019 9:45 am

Randomized Controlled Trial to Examine the Impact of Aquatic Exercise Training on Functional Capacity, Balance, and Perceptions of Fatigue in Female Patients With Multiple Sclerosis (2018)
https://www.sciencedirect.com/science/a ... 9317304719

"Results
Thirty-two women completed the 8-week aquatic training intervention (experimental group, n=17; control group, n=15). All outcome measures improved in the experimental group: 6-MWT performance (pretest mean ± SD, 451±58m; posttest mean ± SD, 503±57m; P<.001); BBS (pretest mean ± SD, 53.59±1.70; posttest mean ± SD, 55.18±1.18; P<.001), and MFIS (pretest mean ± SD, 43.1±14.6; posttest mean ± SD, 32.8±5.9; P<.01). A significant group-by-time interaction was evident between the experimental and control groups for 6-MWT (P<.001, partial eta2 [ηp2]=.551), BBS (P<.001, ηp2=.423), and MFIS (P<.001, ηp2=.679).

Conclusions
Aquatic exercise training improved functional capacity, balance, and perceptions of fatigue in women with MS."
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 » Fri Feb 01, 2019 7:49 am

2019 Jan 3
HealthyFit Research Group, Department of Special Didactics, Faculty of Educational Sciences and Sports, Spain
Pilates for people with multiple sclerosis: A systematic review and meta-analysis.
https://www.ncbi.nlm.nih.gov/pubmed/30623859

..CONCLUSIONS:
Pilates is a feasible therapy for people with MS that can lead to improvements on their physical function, and it might be helpful for reducing self-perceived fatigue. The potential beneficial effects of Pilates are not significantly greater than those derived from the performance of other physical therapies. Further high-quality RCTs are needed to consolidate the existing scientific evidence regarding the impact of Pilates on this population.

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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 » Fri Feb 08, 2019 12:22 pm

2019 Jan 18
Department of Physiology and Immunology, University of Rijeka Faculty of Medicine, Croatia
Exploring the feasibility of a mild and short 4-week combined upper limb and breathing exercise program as a possible home base program to decrease fatigue and improve quality of life in ambulatory and non-ambulatory multiple sclerosis individuals.
https://www.ncbi.nlm.nih.gov/pubmed/30659416

Abstract
PURPOSE:
To evaluate the feasibility of a combined upper limb and breathing exercise for a home-based program and to explore its effect on primary fatigue and quality of life in ambulatory and non-ambulatory individuals with multiple sclerosis (MS) in a short time.
METHOD:
Nineteen individuals with MS were assigned into semi-controlled pre-post feasibility study based on Expanded Disability Status Scale (EDSS) status and divided into two groups: exercise (five ambulatory, five non-ambulatory; EDSS 1.0-8.0) and related control with no exercise (four ambulatory, five non-ambulatory; EDSS 1.0-7.5). Exercise group performed combined upper limb and breathing exercise in a controlled group (2 days/week, 60 min/session) accompanied by independent home exercise (3 days/week, ≥ 20 min/session). Participants underwent measures of fatigue impact (Modified Fatigue Impact Scale (MFIS) and quality of life (RAND Medical outcomes study 36-item short-form health survey (SF-36)) before and after a 4-week period.
RESULTS:
The MFIS (physical, psychosocial, total) showed statistically significant group-by-time interaction in ambulatory (p = 0.033, d = 1.60; p = 0.039, d = 1.59; p = 0.033, d = 1.62) and non-ambulatory individuals (p = 0.009, d = 2.42; p = 0.018, d = 1.96; p = 0.0008, d = 3.92). Physical functioning (SF-36) showed statistically significant group-by-time interaction in ambulatory (p = 0.014, d = 2.14) but no significance in non-ambulatory (p = 0.368, d = 0.68) individuals. Despite the absent statistical significance, there were large intervention effects on MFIS cognitive scores for ambulatory (d = 1.28) and non-ambulatory (d = 1.47), and on other SF-36 scores for ambulatory (general health: d = 1.76 and pain: d = 1.02) and non-ambulatory (physical limitation: d = 1.03 and emotional well-being: d = 0.94) individuals.
CONCLUSION:
Our 4-week program reduced some aspects of fatigue and improved some aspects of quality of life in a small group of ambulatory and non-ambulatory individuals with MS. Good feasibility and significant positive changes from baseline warrant further exploratory work.
TRIAL REGISTRATION:
Name of the registry: The Impact of Exercise Training on Living Quality in Multiple Sclerosis. Registration: The study was registered at www.clinicaltrial.gov on July 14, 2017. First participant enrollment: August 28, 2017. URL: 602-01/17-01-147; Trial registration ID: NTC03222596.

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